It gets earlier every year

Fears of a winter crisis began with the usual warnings about overstretched wards, cancelled appointments, and a health service “sleepwalking into disaster”.

Like last year, and the year before, health professionals are “concerned” or “extremely concerned” about their organisation’s ability to cope with flu season.

However, unlike previous years, the Health Secretary has publicly admitted he is “worried”, and his concern is justified – in the winter of 2014-15 there were an estimated 43,900 excess deaths in England and Wales, the highest number since 1999. Despite the mild weather and low infection rates last year, A&E waiting times were among the worst on record.

The impact is not only felt in urgent care – the Society for Acute Medicine has warned that if services are “overwhelmed” by flu season, thousands of operations could be cancelled, disrupting the NHS well into 2018.

Prevention is better than cure, so health officials launched their annual Stay Well This Winter campaign, urging at-risk groups to be vaccinated against flu, hopefully easing the pressures on underfunded hospitals and overworked staff.

The Public Health England-led campaign is the same as last year, and the year before, which recalls the adage about doing the same thing and expecting different results – and has led to accusations that the Government is doing little more than hoping for the best.

Even the best of intentions, such as a nasal spray vaccine for children, are now met with dissent. Professional contrarian Katie Hopkins says her son will not receive the ‘herd’ flu vaccination because “my son is not an animal, and I am not a sheep”.

Regardless of tabloid misanthropy, there might not be enough nurses to immunise those at risk – the Royal College of Nursing chief executive Janet Davies said: “A lethal cocktail of extreme pressure inside the NHS, a collapse in European nurses and falling pay levels left the profession demoralised and people heading for the door.”

The Government has pledged to create 5,000 extra trainee home-grown nurses and lifted the pay cap freeze, but this will do little to improve the current situation. Acknowledging the need for urgent action, Jeremy Hunt has floated the idea of stopping walk-in patients from attending emergency departments – “talk before you walk”, referring to the 111 telephone triage system.

NHS England has denied it plans to pilot the idea, but Dr Helen Thomas, the national medical adviser for integrated urgent care, said Mr Hunt was considering testing the idea.

Whatever the clinical justification, it is politically toxic – in response the Opposition accused the Government of “an abdication of responsibility.”

Australia and New Zealand are currently experiencing their worst flu outbreaks on record, and Simon Stevens, fearing the implication for the northern hemisphere, is aware their hospitals “have struggled to cope”.

Perhaps it is too late to reduce the impact of winter in 2017-18. Repeating last year’s campaign, on the same schedule, appears to be too little, too late. The NHS needs to prepare for the winter during the summer months – a daunting challenge for public health marketers. No one wants to think about ice and rain during August, but flu is coming, and it gets earlier every year.

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